Chemotherapy -induced peripheral neuropathy ( CIPN ) is one of the most common adverse effects in chemotherapy .The mechanism of CIPN has always been attracting researchers′attention.Recently,the intimate relationship between nerve growth factor and CIPN is one of the most hot topics .NGF protects neurons from damage of chemotherapy drugs through inhibiting apoptotsis and other pathway to relieve the neurotoxicity . However ,there are still many problems in the clinical application of exogenous NGF .To improve the mechanism of NGF in the development and application approach of CIPN ,treatment of chemotherapy -induced peripheral neu-rotoxicity is of great significance .

OBJECTIVETo study the chemical constituents of Acanthus ilicifolius.

METHODChromatographic methods were used to isolate compounds from A. ilicifolius, and chemical and spectroscopic methods were used to elucidate the structures of the isolated compounds.

RESULTSeven compounds, betaine (1), phenylethyl-O-beta-D-glucopyranosyl- (1-->2) -beta-D-glucopyranoside (2), phenylethyl-O-beta-D-glucopyranoside (3), acteoside (4), isoacteoside (5), benzyl-O-beta-D-glucopyranoside (6) and vanillic acid (7) were obtained.

CONCLUSION1, 3, 6 and 7 were obtained from the genus for the first time.

Acanthaceae ; chemistry ; Betaine ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Vanillic Acid ; chemistry ; isolation & purification

Objective To examine the effect of aqueous and ethanol extracts of Coix lacryma-jobi stem on the growth of mouse S180 sarcoma cells in mice.Methods Tumor growth inhibition assays were performed using both aqueous and ethanol extracts of Coix lacryma-jobi stem.Specific-pathogen-free (SPF) Kunming mice,6-8 weeks old,were inoculated with 1 × 107 cells · mL-1 S180 sarcoma cells in a volume of 0.4 mL The next day,the mice were randomly divided into blank group,control group,experimental-H,experimental-M,experimental-L doses groups,and administered with 0.9％ NaC1,cyclophosphamide (20 μg · g-1 · d-1) or Coix lacryma-jobi stem extract (1 000,500,250 mg · kg-1 · d-1) respectively by gavage or tail vein injection for 10 d.The tumor and spleen were dissected and weighed.The tumor inhibition rate was calculated.Results Tumor growth inhibition ratios in the experimental-H,experimental-M,experimental-L groups by the aqueous extract of Coix lacryma-jobi stem were 32.11％,75.63％ and 11.41％,respectively.Tumor growth inhibition ratios for experimental-H,experimental-M,experimental-L groups by the ethanol extract of Coix lacryma-jobi stem groups were 77.09％,80.03％ and 73.52％,respectively.Conclusion Each dose of water or ethanol extract of Coix iacryma-jobi stem was able to inhibit the growth of S180 sarcoma to a degree,and exhibited few adverse reactions.The optimal dose of the aqueous extract was 500 mg · kg-1 · d-1.

Objective To investigate the optimal distance between upper and lower target volumes and their correlated planning parameters by analyzing the dose distribution in the abutment regions during total body irradiation ( TBI) using helical tomotherapy. Methods A total of 10 patients with acute leukemia and with a height around 120 cm were enrolled. All patients were scanned by a Siemens simulation computerized tomography (CT) at a slice thickness of 5 mm. A lead wire was placed 10. 0 cm above the patella as a marker of the separation boundary for the upper and lower target volumes. The delineations of target volumes and organs at risk ( OARs ) were performed in the Varian Eclipse 13. 5 workstation with targets shrunk beyond the separation boundary at different distances. After contours and CT images were transferred to HT workstation, treatment plans were designed with different field width (FW, 5. 0 cm/2. 5 cm/1. 0 cm) and pitch values (0. 430/0. 287) at a modulation factor of 1. 8. All the plans were optimized with a dose calculation grid of 0. 195 cm × 0. 195 cm and identical planning parameters. The correlation between treatment planning parameters and targets shrunk distances were investigated by analyzing the dose distributions in the abutment area. Results The study demonstrated that the dose distributions in the abutment area were influenced only by the field width parameters: when the gap distance between the upper and lower targets was 5. 0 cm, the optimal FW is 5. 0 cm;Similarly when the gap distances were 2. 0 cm and 1. 0 cm, and the optimal FW 2. 5 cm and 1. 0 cm, respectively. In another words, the dose distribution of the abutment region was optimal when the target gap distance was equal to FW. Pitch values did not affect the quality of dose distribution in the abutment region and the overall treatment time ratio. Overall treatment time was inversely related to the FW. Conclusions Consistent target distance and FW is helpful to improve the dose homogeneity in the abutment area during TBI with HT. Appropriate planning parameters is critical to balance the treatment efficacy and efficiency.

Objective To investigate the intra- and interobserver repeatability of coronary artery disease (CAD) diagnosis based on invasive coronary angiography (ICA) and CT coronary angiography (CTCA).Methods Two readers with comparable experience ( over 10 years) independently evaluated ICA results of 42 consecutive patients with a blind method. After 30 days,one of them reviewed the same patients again.Another two comparable-experience (over 10 years) readers evaluated the results of CTCA (prospectively ECG-triggering) from the same 42 patients in the same way.The inter-reader and intra-reader repeatability of ICA and CTCA were analyzed by performing Kappa test and calculating the percentage of the segments with agreement on stenotic degree.Using ICA as reference,the accuracy of CTCA in diagnosing CAD was studied by comparing the area under ROC. Results The Kappa between readers for ICA and CTCA were 0.91 and 0.81.Intra-reader Kappa were 0.92 and 0.83 respectively (x2 =509.4 and 432.5,all P ＜0.01 ).The percentage of the segments with agreement between readers on the degree of stenosis were 80.8％ (494/611) in ICA and 75.2％ (469/624) in CTCA ( x2 =2.75,P =0.10),and within the same reader,86.9％ (531/611)in ICA and 81.9％ (511/624) in CTCA(x2 =3.76,P =0.053).With≥ 50％narrowing as a CAD diagnosis criterion,the agreement rates for two readers were 96.6％ (590/611 ) in ICA and 94.4％ (589/624) in CTCA( x2 =3.36,P =0.07),and for the same reader,97.4％ (595/611) in ICA,95.4％ (595/624) in CTCA ( x2 =3.62,P =0.06).Using ICA as reference,two readers of CTCA results achieved a sensitivity and specificity of 84.9％ (530/624)and 98.1％ (612/624).The area under ROC was 0.94 (95％ CI 0.91-0.97).Conclusions Both ICA and CTCA demonstrate good repeatability in diagnosing CAD.The repeatability of ICA is superior to that of CTCA.A certain discrepancy exists in two readings from the same reader or two readers.

Objective Aim of the present study was to investigate the effect of ehronic trimetazidine treatment on atrial energy metabolism and endothelial function in a canine model of chronic atrial fibrillation (AF).Methods Eiighteen canines were randomly divided into sham.operated group(n=6),atrial pacing group(n=6),and trimetazidine group(n=6).In atrial pacing group and trimetazidine group,dogs were atrial paced at 400 beats per minutes for 6 weeks.Trimetazidine at 5mg·kg-1·d-1 was given one day before rapid atrial pacing for 6 weeks.Creatine phosphate (CrP),adenosine triphosphate(ATP).adenosine diphosphate (ADP) and adenosine monophosphate (AMP) in atrial tissue were analyzed by high-performance liquid chromatography.Total adenosine(TAN)Was calculated.The expression of endothetial nitric oxide synthase(eNOS)in atrial tissue was determined by Western blot and immunohistochemical staining.In addition,plasma levels of von WiUebrand factor(vWF) was quantified with enzyme-linked immunoadsorbent assay and NO2-/NO3-(NOx) was determined by nitrate reductase method.Results Atrial CrP(P<0.01) and CrP/ATP were significantly decreased in paced atrium compared to atrium from sham-operated group(P<0.05) while ATP,ADP,AMP and TAN remained unchanged (all P>0.05).Plasma vWF Was significantly increased and plasma NOx significantly decreased in paced animals compared to sham-operated animals.Atrial expression of eNOS Was also significantly reduced in paced animals(P

Objective To study the effect of Ilizarov technique on thumb shortening and bone defect after trauma.Methods The clinical data of 20 patients with thumb shortening or bone defect treated by Ilizarov technique from April 2010 to January 2018 were retrospectively analyzed.There were 19 males and 1 female including 15 left fingers and 5 right fingers.The age ranged from 20 to 56 years,with an average of 33.1 years.The osteotomy plane included 9 cases at distal part of the metacarpal,6 cases proximal phalanx base,1 case interphalangeal joint and 1 case distal part of proximal phalanx.Two cases were osteomyelitis after proximal and distal phalanges trauma,which resulted in interphalangeal joint defects after lesion clearance,and the length of the joint defect was 0.5 cm and 0.7 cm respectively.One case was emergency finger shortening fusion,which resulted in metacarpophalangeal joint defect due to nonunion of fusion site,and the length of the joint defect was 0.5 cm.Causes of injury included mechanical strangulation (12 cases),crush injury (6 cases) and traffic injury (2 cases).Semi-ring external fixator was used to extend the extension.There were 15 cases of metacarpal bone osteotomy and 5 cases of proximal phalanx osteotomy,prolonged from the 5th day after surgery.The osteotomy was prolonged by 0.5 mm every day,once every 6 hours.Results The follow-up time ranged from 184 to 446 days with an average of 244.6 days.The average extension period was 62.2 days (26-118 days),and the average extension length was 3.1 cm (1.3-5.9 cm).The healing index was 43.7-84.1 d/cm and the average healing index was 64.8 d/cm.The external fixed extender was used for 114-376 days with an average of 206.3 days.The distraction index was 20.1 c/cm (range,19.5-21.4 d/cm) and the maturity index was 46.5 d/cm (range,39.4-110.1 d/cm) and the external fixation index was 66.5 d/cm (range,60-130.8 d/cm).The finger pointing function and sensory function of thumb were restored after operation.According to the trial criteria of thumb and finger reconstruction function evaluation in the upper limb part evaluation criteria of Hand Surgery Society of Chinese Medical Association,11 cases were excellent,9 cases good,and the excellent and good rate was 100％(20/20).The two-point discrimination was 4-9 mm.The patients were satisfied with the function and appearance.Conclusion Ilizarov technique is a good method to treat thumb shortening and bone defect after trauma.

Objective To discuss the safety, feasibility and advantages of tubeless trans-subxiphoid thoracoscopic surgery in anterior mediastinal tumor resection. Methods A total of 32 patients suffering anterior mediastinal tumor were enrolled, including 17 patients (8 males and 9 females) with average age of 31.8±8.4 years who had been performed tubeless trans-subxipohoid tharcoscopic surgery and 15 patients (8 males and 7 females) with average age of 31.1±9.2 years who had been performed traditional trans-subxipohoid tharcoscopic surgery. The differences of surgical duration, the lowest intraoperative arterial oxygen saturation (SaO2), postoperative awaking time, postoperative pain visual analogue score (VAS), postoperative pulmonary recruitment time, duration of postoperative hospital stay and hospitalization cost were analyzed. Results Postoperative awaking time (18.5±1.8 min vs. 28.9±4.2 min, P=0.000), postoperative VAS (1.6±0.6 vs. 3.5±7.4, P=0.000), duration of postoperative hospital stay (2.5±7.2 d vs. 4.3±1.1 d, P=0.000) and hospitalization cost (3.2±1.1 ten thousand RMB vs. 4.9±1.1 10 ten thousand RMB, P=0.000) in the tubeless group were better than those in the control group. There was no significant difference in surgical duration (51.7±6.5 min vs. 55.1±8.5 min), the lowest intraoperative SaO2 (98.5%±0.9% vs. 98.1%±0.8%), postoperative pulmonary recruitment time (33.9±12.2 d vs. 38.4±15.2 d, P>0.05) between the two groups. Conclusion Tubeless trans-subxiphoid thoracoscopic surgery is safe, feasible and advanced in anterior mediastinal tumor resection.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome